Things Look Good

We have, unofficially, what is called a "Partial Response." That's good news. Dr. R says we are "moving in the right direction."

Before my fourth (and last scheduled) Rituxan infusion today, Dr. R gave me the long-awaited physical exam. The nodes near my hip bone are smaller and flatter, and the swelling in my leg has gone done and seems "not as hard as before." All of that translates into a "Partial Response" -- not completely wiping it out, but wiping out some of it.

(A Partial Response (PR) is, of course, not as good as a Complete Response (CR), though with something slow-growing like Follicular NHL, a PR is still significant, since relapse is likley anyway. I don't know for sure, but I think treatments are approved for fNHL based on both PR and CR rates, not just CR, which tells you something about how valuable a PR is.)

So, given that we're having some success, he's going to extend the Rituxan for two more weeks, for a total of six rounds. What he saw today was the result of three rounds, so if he considers the results today to be about 50% of what we can expect at the end, then we'll have knocked it back pretty well.

After the 6th round, I'll have some kind of pictures taken of my insides, so we can see for sure what's going on. It will probably be an MRI or an ultrasound, rather than a CT or PET scan, so I can hold off on getting any more radiation for now.

If things continue to go as well as expected, and we end up with a significant Partial Response, then we have several options after the 6th round of Rituxan: we could try two more rounds of Rituxan; we could do nothing and just go back to watching and waiting; we could try a mild chemo like Chlorambucil (a pill I could take at home); or a slightly more aggressive chemo like CVP.

At this point, Dr. R is leaning toward watching and waiting, assuming things go as he expects; he thinks even if it's just a Partial Response, the CVP is probably too aggressive at this point.

I'm OK with all of that. It's roughly the plan that I would have gone with. (Always nice when my doctor agrees with me.)

Chlorambucil is a new possibility for me, so I haven't ever talked about it here before. Don't know much about it, to tell you the truth. But I did do a very quick Google search to make sure I had the spelling right, and that Google feature that automatically suggests search terms for you came up with "Chlorambucil for Cats." I chose not to explore that option; the new mouse part of me was in emotional turmoil. (Probably no more Minnie Mouse fantasies with the Chlorambucil; might end with a Tom and Jerry fantasy instead.....)